Objective To assess the usefulness of a computer-aided detection(CAD)system on detecting the pulmonary nodules in digital chest radiography.Methods Three hundred and twenty-eight digital chest radiographies along with corresponding chest computed tomography were selected for this study. Two senior chest radiologists interpreted these cases using the CAD system and marked the locations and sizes of all nodules with consensus,which were stored in a computer system as Gold Standard to evaluate the performance of the CAD system.Eight radiologists of various experience read these selected cases without and with the aid of CAD system and their results were stored in a computer system.The radiologists' performance was evaluated by using the receiver operating characteristic analysis.Comparison is made regarding the difference in Az values when CAD was not used versus when CAD was used by using the paired-samples t test.Results For small nodules,the sensitivity of this computer system used by the two senior chest radiologists in 100 digital radiographs was 78.1%(118.0/151).Without and with the assistance of CAD system,the nodule detection sensitivity of the radiology residents was 62.4% (94.2/151),77.4%(116.8/151)respectively,and the area under the curve of radiology residents was 0.769,0.836 respectively.Statistical analysis showed there was statistically significant difference between interpretation without and with the CAD system(P0.05).Conclusions This CAD system can help to enhance the radiologists' ability to detect small pulmonary nodules.This is especially helpful for radiology residents.

Objective To evaluate abdominal imaging in AIDS.Methods The imaging examinations(including US,CT and MR)of 6 patients with AIDS associated abdominal foci were analysed retrospectively.All the cases were performed US,and CT scan,of which 4 performed enhanced CT scan and 1 with MR.Results Abdominal tuberculosis were found in 4 patients,including abdominal lymph nodes tuberculosis(3 cases)and pancreatic tuberculosis(1 case).The imaging of lymph nodes tuberculosis typically showed enlarged peripheral rim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement.Disseminated Kaposi's sarcoma was seen in 1 case:CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles.Pelvic tumor was observed in 1 case:CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity.Conclusion The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease.Tissue biopsy is needed to confirm the diagnosis.

Objective To evaluate the clinical value of 6 h 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) planar hepatobiliary scintigraphy (HBS),6 h tomographic HBS and 24 h planar HBS in diagnosis on biliary atresia(BA).Methods Seventy cases(32 male,38 female) with continuous jaundice received planar and tomographic HBS in Beijing Friendship Hospital from Jan.2005 to Dec.2007.The mean age was 48.7 d (29 d-4 months).According to final diagnosis,all cases were divided into BA group (45 cases) and non-BA group (25 cases).All cases fasted at least 4 hours before HBS.The equipment was 3 head IRIX from Philips company with low energy high resolution collimator.The tracer was 99mTc-EHIDA and the radiochemistry purity was more than 95 percent.The dosage was 7.4 MBq/kg.All diagnosis demonstrated by operation pathology and clinical follow-up.All cases received HBS at 5,10,15,20,30 min and 1,6 h after tracer injection.HBS would ended if radioactivity appeared in gallbladder or intestine.These cases would received tomographic HBS and 24 h HBS if radioactivity did not appear in gallbladder or intestine at 6 h post injection.All these images were analyzed by 2 or more nuclear medicine physicians.Results There were not radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 27 cases,which suggested the BA.There were radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 30 cases,which suggested the non-BA.Positive rate of 6 h tomographic HBS was significantly higher than that of 6 h planar HBS and there was significantly difference between the 2 methods.Positive rate of 6 h tomographic HBS was significantly higher than that of 24 h planar HBS and there was significant difference between the 2 methods.Conclusions 99mTc-EHIDA HBS is a noninvasive,safety,valuable examing method and has definitely clinical value in the diagnosis on BA.The clinical value of 6 h tomographic HBS is significantly higher than that of 6 h planar HBS and 24 h planar HBS.

Humans ; Image Processing, Computer-Assisted ; Lung ; diagnostic imaging ; Pneumoconiosis ; diagnostic imaging ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods

BACKGROUNDComputer-aided diagnosis (CAD) of lung cancer is the subject of many current researches. Statistical methods and artificial neural networks have been applied to more quantitatively characterize solitary pulmonary nodules (SPNs). In this study, we developed a CAD scheme based on an artificial neural network to distinguish malignant from benign SPNs on thin-section computed tomography (CT) images, and investigated how the CAD scheme can help radiologists with different levels of experience make diagnostic decisions.

METHODSTwo hundred thin-section CT images of SPNs with proven diagnoses (135 small peripheral lung cancers and 65 benign nodules) were analyzed. Three clinical features and nine CT signs of each case were studied by radiologists, and the indices of qualitative diagnosis were quantified. One hundred and forty nodules were selected randomly to form training samples, on which the neural network model was built. The remaining 60 nodules, forming test samples, were presented to 9 radiologists with 3 - 20 years of clinical experience, accompanied by standard reference images. The radiologists were asked to determine whether a nodule was malignant or benign first without and then with CAD output. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis.

RESULTSCAD outputs on test samples had higher agreement with pathological diagnoses (Kappa = 0.841, P < 0.001). Compared with diagnostic results without CAD output, the average area under the ROC curve with CAD output was 0.96 (P < 0.001) for junior radiologists, 0.94 (P = 0.014) for secondary radiologists and 0.96 (P = 0.221) for senior radiologists, respectively. The differences in diagnostic performance with CAD output among the three levels of radiologists were not statistically significant (P = 0.584, 0.920 and 0.707, respectively).

CONCLUSIONSThis CAD scheme based on an artificial neural network could improve diagnostic performance and assist radiologists in distinguishing malignant from benign SPNs on thin-section CT images.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Lung ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Neural Networks (Computer) ; ROC Curve ; Radiographic Image Interpretation, Computer-Assisted ; Solitary Pulmonary Nodule ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo observe the protective effect of ischemic postconditioning on ischemic reperfusion injury of rat liver graft and to investigate the possible mechanism.

METHODSMale Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, and the period of cold preservation and anhepatic phase were 100 min and 18 min, respectively. Sixty rats were randomly divided into three groups, twelve rats in control group, twenty-four rats in ischemic reperfusion injury group and ischemic postconditioning group respectively. Control group is sham operation group, only the ligaments around liver were cut off; donor livers in ischemic reperfusion injury group were infused through portal vein with heparinized saline before harvested; ischemic postconditioning group: at very onset of reperfusion after donor liver was implanted, several brief reperfusion-ischemia were given before persistent reperfusion of portal vein. Half recipients of ischemic reperfusion injury group and ischemic postconditioning group were taken blood samples and hepatic tissue samples after 2 hours of reperfusion of liver graft. Rest recipients were taken samples of hepatic tissue after 6 hours of reperfusion. Recipients of control group were taken blood and hepatic tissue samples at corresponding time after abdomen was sutured.

RESULTSCompared with ischemic reperfusion injury group, liver functional parameters, cytokines and peroxidized products contents were lower in ischemic postconditioning group (P < 0.05); meanwhile, the antioxidases contents of hepatic tissue were higher in ischemic postconditioning group than those in ischemic reperfusion injury group (P < 0.05).

CONCLUSIONSIschemic postconditioning could relieve the ischemic reperfusion injury of rat liver graft. Through improving antioxidation capability and cutting down cytokines contents, ischemic postconditioning could apply its protective effect.

Animals ; Glutathione Peroxidase ; metabolism ; Leukocyte Elastase ; blood ; Liver ; blood supply ; metabolism ; Liver Transplantation ; Male ; Malondialdehyde ; metabolism ; Peroxidase ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; prevention & control ; Superoxide Dismutase ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo study the effects of Liangge San to the expression of CD14 and scaverger receptor(SR) in the kupffer cells of liver and the pathological changes of liver tissue of endotoxemia-mice.

METHODThe model was established with intravenous injection of lipopolysaccharide (LPS) and at the same time different dose Liangge San were given. The expression of CD14 and scaverger receptor were detected with immunohigtochemistry at the 2nd, 4th, 8th hour ofter injury and analyzed with computer image system, and the pathological changes of liver tissue were also observed.

RESULTAt the three different hours, the expression of CD14 and scaverger receptor in macrophages of liver of LPS-injury group showed significant increase and significant decrease respectively, compared with that of the blank-control group (P < 0.01). The expression in dexamethasone group and Liangge San different dose groups were intermediate between those in injury group and those in control group. Compared with expression of LPS-injury group, those of dexamethasone group and Liangge San different dose groups showed significant differences (P < 0.01), especially that of Liangge San high dose group. Liver cells showed vacuole change. Changes of CD14 and SR expression were paralleled with the severity of liver damages of the mice.

CONCLUSIONLiangge San can inhibite the up-regulation of CD14 expression and down-regulation of scaverger receptor expression in a dosage-dependent manner and also alleviate the damages of liver induced by LPS.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Dexamethasone ; pharmacology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Endotoxemia ; chemically induced ; metabolism ; pathology ; Female ; Kupffer Cells ; metabolism ; pathology ; Lipopolysaccharide Receptors ; metabolism ; Lipopolysaccharides ; Liver ; metabolism ; pathology ; Mice ; Plants, Medicinal ; chemistry ; Receptors, Scavenger ; metabolism

OBJECTIVETo evaluate imaging of high-resolution computed tomography (HRCT) for nodules of cadaveric lungs of coal workers' or coal workers with coal workers' pneumoconiosis (CWP) and to determine types of small nodules of CWP and dust speckle based on CT-pathologic correlation.

METHODSThirty-two entire lung specimens were available from autopsy of the patients with CWP and coal workers occupationally exposed to coal dusts. They comprised 25 workers without CWP, 3 patients with 0+ stage and 4 patients with I stage. Thirty-two lung specimens were inflated and fixed by Heitzman's method, and underwent coronal single slice computed tomography (SSCT)/multi-slice computed tomography (MSCT) and HRCT scans. Gross specimens section (50 approximately 100 microm of slice thickness) and histological section (5 approximately 8 microm of slice thickness) were performed on seventeen pieces of 10 mm-thickness slices of lung specimen in thirteen cases. The nodules were divided into round, ill defined and stellate-shaped, and their distributions and relationships with pulmonary lobule were analyzed.

RESULTSThe findings were as follows (1) 14 cases without CWP and 18 cases with CWP (including 5 cases with I stage 11 cases with II stage and 2 cases with III stage) were diagnosed by pathology. (2) Nodules were displayed on HRCT in 32 cases, among which 29 cases were verified by pathology. There was no significant difference between HRCT and pathology (chi2 = 0.5, 0.25 < P < 0.5). (3) Nodules of CWP on HRCT included well-defined round nodules, ill defined nodules and stellate-shape nodules. Twelve of fourteen round nodules on HRCT were pathologically typical ones. Twenty-six ill defined nodules on HRCT included 14 atypical ones, 11 dust macules and 1 typical one by pathology. Six dust macules and 3 atypical nodules were found by pathology in nine stellate-shape nodules on HRCT. (4) HRCT accurately displayed nodular distributions including nodules adjacent to small artery, thickened septa and subpleural regions.

CONCLUSIONHRCT could display typical, atypical nodules and some dust macules presenting pathologic changes, as well as relationship between nodules and structure of pulmonary lobule.

Aged ; Aged, 80 and over ; Coal Mining ; Dust ; Humans ; Lung ; diagnostic imaging ; pathology ; Middle Aged ; Tomography, X-Ray Computed ; methods

Adolescent ; Adult ; Aged ; Ankle Injuries ; surgery ; Child ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Sural Nerve ; Surgical Flaps ; Young Adult